Tanaka M, Akahoshi K, Chijiiwa Y, Sasaki I, Nawata H
Third Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Am J Gastroenterol. 1995 Apr;90(4):662-3.
Using endoscopic ultrasonography, we diagnosed a gastric antral submucosal cyst with a papillous protrusion in a 71-yr-old woman, apparently the first such case to be detected by this method. Endoscopic ultrasonography demonstrated a well-marginated hypoechoic area with papillary tumor in the submucosal layer that did not extend to the muscularis propria. The lesion was diagnosed as a gastric submucosal cyst. CT and transabdominal ultrasound each failed to detect the intracystic papillary tumor. Follow-up endoscopic ultrasonography performed 6 months later revealed an increase in the diameter of the cyst and the papillary tumor. The patient then underwent a partial gastrectomy for a suspected malignancy. The resected specimen showed a cystic lesion with papillary tumor. Although no malignancy was present, examination of cross-sections of the resected specimen gave results consistent with the endoscopic ultrasonographic findings. Endoscopic ultrasonography is thus useful in assessing the nature of a submucosal gastric cyst in detail and in monitoring patients with this lesion.
我们通过内镜超声检查，诊断出一名71岁女性患有胃窦黏膜下囊肿并伴有乳头状突起，这显然是首例通过该方法检测到的此类病例。内镜超声检查显示黏膜下层有一个边界清晰的低回声区，伴有乳头状肿瘤，未延伸至固有肌层。该病变被诊断为胃黏膜下囊肿。CT和经腹超声均未能检测到囊内乳头状肿瘤。6个月后进行的随访内镜超声检查显示囊肿和乳头状肿瘤直径增大。随后，该患者因疑似恶性肿瘤接受了部分胃切除术。切除标本显示为伴有乳头状肿瘤的囊性病变。尽管未发现恶性肿瘤，但对切除标本横截面的检查结果与内镜超声检查结果一致。因此，内镜超声检查有助于详细评估胃黏膜下囊肿的性质，并对患有该病变的患者进行监测。
